Der Internist
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Coronavirus disease 2019 (COVID-19) continues to pose a major global threat. Although a wide range of organ manifestations have now been described, the respiratory system remains in the forefront in terms of the course of infection. Severe pneumonia can develop and is generally prognostically relevant. ⋯ This is followed by a description of symptoms, which develop in three phases. With regard to treatment, supportive and intensive care approaches are discussed, including O2 administration and (non-)invasive ventilation. The article concludes with a summary of the insights gained into pharmacological therapies: thrombosis prevention on the one hand, and specific antiviral and immunomodulatory therapies (remdesivir, tocilizumab, anakinra, dexamethasone) on the other.
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Skin diseases represent the second most common paraneoplastic manifestations after endocrine disorders. Paraneoplastic dermatoses may arise as the first clinical sign of occult malignancies, or manifest during the course of a previously diagnosed neoplasm. Dermatoses belonging to the group of obligate paraneoplastic syndromes manifest only in the presence of underlying malignancies. Other skin diseases may be associated with malignancy in a subset of patients.
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Case Reports
[Proximal myopathy and fulminant heart failure in a 57 year-old female patient with lupus erythematosus].
A case report is presented of fulminant hydroxychloroquine-induced cardiomyopathy in a 57 year-old female patient with a long history of systemic lupus erythematosus. Diagnosis was established based on clinical findings, imaging (echocardiography and cardiac magnetic resonance imaging) as well as endomyocardial biopsy. Despite immediate discontinuation of the medication, the patient died from heart failure within a few days. Since the rare adverse effect described here might be reversible, early diagnosis and discontinuation of hydroxychloroquine are crucial for the prognosis of these patients.